Abstract

Purpose: Post-operative posturing and choice of intraocular tamponade remain contentious issues in macularhole surgery. We report the results of non-posturing surgery, with choice of tamponade guided by macular holesize.Methods: In this retrospective consecutive case series, patients underwent non-posturing 23Gvitrectomy/phacovitrecomy and ILM peel for idiopathic full-thickness macular holes. Pre-operative hole basediameter was measured using spectral domain OCT. Macular holes with a base diameter (BD) of ≤ 720 μm weretamponaded with 20% SF6(Sulfur hexafluoride), while larger holes received 20% C2F6 (perfluoro-ethane). Theprimary hole closure rate and improvement in vision was recorded.Results: 58 eyes in the SF6 group had a mean macular hole base diameter of 504.8μm (range 95-733μm). 28eyes in the C2F6 group had a mean macular hole BD of 963.0μm (range 722-1440μm). The primary surgicalsuccess rate was 93.5% in the SF6 group and 92.9% in the C2F6 group. Using a Z-test for the equality of twoproportions, the proportions of successful procedures in cases with SF6 and C2F6 agents were found to be notsignificantly different (Z=0.122; p=0.903).Conclusion: Short acting SF6 gas and medium acting C2F6 gases were effective in closing macular holes withan average preoperative macular hole BD of 504.8 μm and 963.0 μm respectively. Further studies are requiredto determine, the optimum tamponade guided by preoperative macular hole size.